Incidence and Type of Errors in Microsurgical Technique in Surgical Trainees

J Reconstr Microsurg. 2016 Sep;32(7):528-32. doi: 10.1055/s-0036-1581077. Epub 2016 Apr 6.

Abstract

Background The purpose of our study was first to identify microsurgical errors and their incidence. Identifying these common errors and the theoretical approach to prevent or repair them may provide benefit to trainees in the laboratory setting and, ultimately, in the clinical setting. Methods Using a rat femoral artery anastomoses model for resident microsurgical training, direct staff observation with real-time feedback and error identification was employed. Types of microsurgical errors were recorded and instructor feedback relayed to five resident participants. Results Errors were cataloged into five main categories: insufficient approximation (26.1%), vessel backwall (21.7%), incomplete bites (19.6%), tissue tear (19.6%), and irregular widths (13.0%). Further subdivision of the incomplete bite error based on vessel layer violated was performed. Representative figures were created outlining these errors. Conclusions We present common microsurgical errors in trainees and a training model with synchronous feedback. Visual images were designed outlining these errors as an adjunct for teaching.

MeSH terms

  • Anastomosis, Surgical / education*
  • Anastomosis, Surgical / standards
  • Animals
  • Clinical Competence / standards*
  • Disease Models, Animal
  • Femoral Artery / surgery*
  • Guideline Adherence
  • Humans
  • Incidence
  • Internship and Residency
  • Medical Errors / statistics & numerical data*
  • Microsurgery* / education
  • Microsurgery* / instrumentation
  • Pilot Projects
  • Rats
  • Suture Techniques / education*
  • Suture Techniques / standards
  • Vascular Surgical Procedures / education*
  • Vascular Surgical Procedures / standards